Detection of Asymptomatic Cerebral Microbleeds

Stehling, Christoph; Wersching, Heike; Kloska, Stephan P.; Kirchhof, Paulus; Ring, Janine; Naßenstein, I.; Allkemper, Thomas; Knecht, Stefan; Bachmann, R.; Heindel, Walter

doi:10.1016/j.acra.2008.01.013

Cited by 78 publications

(43 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition, the microbleed conspicuity improved at 3T. 18,23 These results are in line with our results of a better detection of microbleeds at 7T, indicating that the detection of microbleeds improves with increasing field strength. The higher resolution, higher SNR, and increased susceptibility effect at 7T increased the conspicuity of smaller microbleeds.…”

Section: Discussionsupporting

confidence: 82%

See 1 more Smart Citation

Cerebral Microbleeds on MR Imaging: Comparison between 1.5 and 7T

Conijn

Geerlings²,

Biessels³

et al. 2011

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 82%

“…However, studies comparing 1.5T and 3T show a higher number of microbleeds at 3T. 18,23 As the susceptibility effect scales with the magnetic field, scanning at higher field strengths improves the sensitivity to microbleeds. At ultrahigh field strengths, such as 7T, the susceptibility effect further increases as does the SNR.…”

mentioning

confidence: 99%

Cerebral Microbleeds on MR Imaging: Comparison between 1.5 and 7T

Conijn

Geerlings²,

Biessels³

et al. 2011

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

show abstract

“…Differences in the frequency of CMBs in our cohort compared with others might be explained by median age and applied field strength (we used 3 T compared with 1.5 T in previous studies). [10][11][12]15,18,27 The increase of sICH and PH with higher baseline CMB numbers is consistent with the hypothesis that an underlying bleeding-prone vasculopathy associated with multiple CMBs promotes genesis of sICH and PH after IVT. The increased rate of hemorrhagic complications in those with a higher number of CMBs might reflect the presence of more severe vasculopathy.…”

Section: Strokesupporting

confidence: 67%

Number of Cerebral Microbleeds and Risk of Intracerebral Hemorrhage After Intravenous Thrombolysis

Dannenberg

Scheitz

Różański

et al. 2014

Stroke

View full text Add to dashboard Cite

Background and Purpose-Cerebral microbleeds (CMBs) are found in a substantial proportion of patients with ischemic stroke eligible for treatment with intravenous thrombolysis. Until now, there is limited data on the impact of multiple CMBs on occurrence of intracerebral hemorrhage (ICH) after intravenous thrombolysis. Methods-Between 2008 and 2013, all patients receiving MRI-based intravenous thrombolysis were identified within our prospective thrombolysis register. Number of CMBs was rated on pretreatment T2*-weighted MRI by a rater blinded to clinical data and follow-up. Outcomes of interest were occurrence of symptomatic ICH (sICH) and parenchymal hemorrhage (PH). Results-Among 326 included patients, 52 patients had a single CMB (16.0%), 19 had 2 to 4 CMBs (5.8%), and 10 had ≥5 CMBs (3.1%). Frequency of sICH/PH was 1.2%/5.7% in patients without CMBs, 3.8%/3.8% in patients with a single CMB, 10.5%/21.1% in patients with 2 to 4 CMBs, and 30.0%/30.0% in patients with ≥5 CMBs, respectively (each P for trend <0.01). The unadjusted odds ratio per additional CMB for sICH was 1.19 (95% confidence interval, 1.07-1.33; P<0.01) and for PH was 1.13 (95% confidence interval, 1.03-1.24; P=0.01). Compared with patients without CMBs, both patients with 2 to 4 CMBs (P=0.02/P=0.02) and patients with ≥5 CMBs (P<0.01/P<0.01) had significantly increased odds ratios for sICH and PH, whereas in patients with a single CMB, odds ratios were not significantly increased (P=0.21/P=0.59). The association of CMB burden with sICH/PH remained significant after adjustment for possible confounders (age, age-related white matter changes score, atrial fibrillation, onset-to-treatment time, prior statin use, and systolic blood pressure on admission). Conclusions-Our findings indicate a higher risk of sICH and PH after intravenous thrombolysis when multiple CMBs are present, with a graded relationship to increasing baseline CMB number. (Stroke. 2014;45:2900-2905.)

show abstract

“…Third, not all patients were scanned at the same field strength, which potentially introduced bias into our results, especially regarding the yield of cerebral microbleeds. 30 However, most patients with microbleeds in our cohort happened to be scanned at 1.5 T (14/17), so we think that possible higher lesion detection of microbleeds at 3T will not have introduced much bias. To further exclude the possibility of bias, we repeated our main analysis with only those patients scanned at 1.5 T, the results remained largely unchanged.…”

Section: Strokementioning

confidence: 99%

Ambulatory Blood Pressure in Patients With Lacunar Stroke

Klarenbeek

Oostenbrugge

Rouhl

et al. 2013

Stroke

195

151

View full text Add to dashboard Cite

Background and Purpose-Asymptomatic lacunar infarcts, white matter lesions, cerebral microbleeds, and enlarged perivascular spaces are MRI markers of cerebral small vessel disease (cSVD). Higher blood pressure (BP) levels are associated with the presence of these markers separately, but the association with the total burden of cSVD on brain MRI, expressed by the simultaneous presence of multiple markers of cSVD (a compound score), has not been investigated. Methods-We performed 24-hour ambulatory BP monitoring in 122 patients with first-ever lacunar stroke. On brain MRI, we scored the presence of each marker of cSVD. One point was awarded for the presence of each marker, producing a score between 0 and 4. Associations with BP levels were tested with ordinal regression analyses. Results-Eighteen (15%) patients had no markers of cSVD, and 6 (5%) patients had 4 markers. Most patients (45; 37%) had 2 different markers. After correction for age and sex, higher 24-hour, day, and night systolic (24-hour odds ratio, 1.25; 95% confidence interval, 1.02-1.52 per 10 mm Hg) and diastolic (24-hour odds ratio, 1.32; 95% confidence interval, 1.12-1.56 per 5 mm Hg) BP were all significantly associated with an increasing total burden of cSVD. Conclusions-We found a positive association of ambulatory BP levels with total burden of cSVD on brain MRI. With increasing BP levels, there is a piling up of damage in the brain. We suggest that further cSVD studies also consider viewing the total burden in addition to each of the MRI markers separately.

show abstract

Detection of Asymptomatic Cerebral Microbleeds

Cited by 78 publications

References 25 publications

Cerebral Microbleeds on MR Imaging: Comparison between 1.5 and 7T

Cerebral Microbleeds on MR Imaging: Comparison between 1.5 and 7T

Number of Cerebral Microbleeds and Risk of Intracerebral Hemorrhage After Intravenous Thrombolysis

Ambulatory Blood Pressure in Patients With Lacunar Stroke

Contact Info

Product

Resources

About